Impact of ergonomics risk among workers in clothes central distribution service in a hospital.

BACKGROUND: In health care services, the workers from laundry and linen services are exposed to various occupational hazards, including the ergonomic risk. Were decided to study the effect of ergonomic factors at work in the musculoskeletal system for employees in this sector. METHODS: Cross-sectional study conducted in a mid-sized general hospital in Brazil. Site visit was conducted to apply recognition of occupational hazards and work activities flow. Medical evaluation of twenty-one workers was performed for designing the health status of them, focusing on orthopedic disorders. RESULTS: Their activities are to distribute clothes in all units of hospital care in order to organize and maintain supplies. The principal complaints were back pain (43%) and shoulder pain (24%). The ergonomic risk happens due to repeated movements of lumbar flexion in sealing, raising the arms above shoulder level in storage and transportation of loads on the distribution of clean clothes. CONCLUSIONS: The complaints by workers are consistent with the overloads identified in the evaluation of jobs. It is recommended to adjust anthropometrically the sealing workplace; the availability of stairs; the implantation of trolleys with four swivel wheels; short breaks during the workday; and to stretch the muscles before and during work.

Musculoskeletal disorder related to the work of doctors who perform medical invasive evaluation.

BACKGROUND: Experts in medical invasive evaluations, like colonoscopy, could be exposed to ergonomic risks during their work. Little attention has been given to these spectrum of occupational health. Its aimed to analyze possible clinical problems related to upper limb of physicians who perform those exams. METHODS: Cross-sectional study in a health service in Sao Paulo, Brazil. For evaluation of the workplace of the colonoscopist physician were applied two tools: Couto's check list and Sue Rodgers Method. The results direct the potential risk to upper limb injuries. RESULTS: The procedure is done and the final report is issued. There are no mandatory pauses during workday. The dominant hand holds the tube insertion with pincer movement during the exam, digital prehension being necessary at times. For this activity the employee has to use some strength. Couto's check list indicates a significant biomechanical factor. Sue Rodgers's Method states high ergonomic risk for dominant hand/wrist/fingers. CONCLUSION: The main risk for the development of health disorders are associated with the use of force and repetitive movements of hands. The adoption of regular breaks to recover most of the structures required is recommended.

Evaluation of lumbar overload in hotel maids.

BACKGROUND: Work-related musculoskeletal disorders are responsible for important amount of declining productivity among workers. Its economic impact is considered important because, in some aspects, such as sickness absence, it can cause increase in costs for employers. This paper aimed at identifying whether the activities that the hotel maids perform during working hours may lead to the development of musculoskeletal disorders. METHODS: Cross-sectional study conducted in a hotel in the city of São Paulo, Brazil. Performed an ergonomic analysis of the job application with a checklist consisting of risk assessment of low back pain. RESULTS: The maids are responsible for the cleaning of hotel rooms, including to lean in order to clean the bathroom. The activity is associated with ergonomic risk for poor posture, manual transport of loads and use of physical force in the upper limbs. This job presents a moderate risk of low back pain according to checklist for assessing the ergonomic situation. CONCLUSIONS: Negative ergonomic aspects are associated with the development or aggravation of musculoskeletal disorders in these workers. We suggest modification in work organisation. Another possibility is decreased the weight of the carts, keeping areas of replacement material on each floor.

Occupational health in Brazil.

Brazil is a recently industrialised country with marked contrasts in social and economic development. The availability of public/private services in its different regions also varies. Health indicators follow these trends. Occupational health is a vast new field, as in other developing countries. Occupational medicine is a required subject in graduation courses for physicians. Specialisation courses for university graduated professionals have more than 700 hours of lectures and train occupational health physicians, safety engineers and nursing staff. At the technical level, there are courses with up to 1300 hours for the training of safety inspectors. Until 1986 about 19,000 occupational health physicians, 18,000 safety engineers and 51,000 safety inspectors had been officially registered. Although in its infancy, postgraduation has attracted professionals at university level, through residence programmes as well as masters and doctors degrees, whereby at least a hundred good-quality research studies have been produced so far. Occupational health activities are controlled by law. Undertakings with higher risks and larger number of employees are required to hire specialised technical staff. In 1995 the Ministry of Labour demanded programmes of medical control of occupational health (PCMSO) for every worker as well as a programme of prevention of environmental hazards (PPRA). This was considered as a positive measure for the improvement of working conditions and health at work. Physicians specialising in occupational medicine are the professionals more often hired by the enterprises. Reference centres (CRSTs) for workers' health are connected to the State or City Health Secretariat primary health care units. They exist in more populated areas and are accepted by workers as the best way to accomplish the diagnosis of occupational diseases. There is important participation by the trade unions in the management of these reference centres. For 30 years now employers organisations have also kept specialised services for safety and occupational health. Although they are better equipped they are less well used by the workers than the CRSTs. At the federal level, activities concerned with occupational health are connected to three ministries: Labour, Health and Social Security. The Ministry of Labour enacts legislation on hygiene, safety and occupational medicine, performs inspections through its regional units and runs a number of research projects. The Ministry of Health provides medical care for workers injured or affected by occupational diseases and also has surveillance programmes for certain occupational diseases. The Ministry of Social Security provides rehabilitation and compensation for registered workers. In spite of a decrease in the number of accidents at work during the past 25 years, working conditions have not improved. Changes in the laws of social security in the 1970s discouraged registration and reporting of occupational injuries and diseases. In consequence death rates due to accidents increased. With the implementation of the CRSTs, the recorded incidence of occupational diseases has risen, not only because of improved diagnosis, but also because of stronger pressure from the unions and better organisation of public services and enterprises.

Aspectos epidemiologicos dos acidentes de trabalho num Hospital Geral. / Epidemiological aspects of occupational accidents in a general hospital

Os autores analisam os acidentes de trabalho ocorridos em um hospital geral no periodo compreendido entre janeiro e dezembro de 1979 e a sua distribuicao entre os funcionarios, objetivando confirmar resultados anteriores e avaliar uma possivel existencia de funcionarios pertencentes a outras categorias profissionais que estariam expostos a riscos. Concluem afirmando que, tambem, e mais elevada a incidencia de acidentes em funcionarios enquadrados em menores faixas salariais, como cozinheiros, seventes de nutricao e de lavanderia e atendentes de enfermagem. Acrescentam, no entanto, a essa relacao outros grupos constituidos por marcineiros - atividade de maior risco - e mecanicos.Destacam a importancia do numero de acidentes com escriturarios e mensageiros, embora esses acidentes se situem entre as categorias de menor risco. Finalmente, propoem que uma estrategia prevencionista em um hospital geral deva levar em consideracao estes achados